{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:24:03Z","timestamp":1760574243605,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015835","name":"Department of Health, Taipei City Government","doi-asserted-by":"publisher","award":["11401-62-047"],"award-info":[{"award-number":["11401-62-047"]}],"id":[{"id":"10.13039\/501100015835","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Adherence to antiretroviral therapy (ART) is critical for HIV management and sustained virological suppression. Differentiating intentional from unintentional nonadherence is essential for developing tailored interventions, yet evidence from Asian populations remains limited. A cross-sectional study of 846 people with HIV (PWH) in northern Taiwan assessed ART adherence using the MARS-5 scale. Participants were categorized into good, unintentional, or intentional non-adherence groups. Logistic regression identified associated behavioral and psychosocial factors. Recreational drug use and younger age were independently linked to both unintentional and intentional poor adherence. Higher income and the use of single-tablet regimens were protective against intentional nonadherence, whereas disclosure of HIV status to a partner and an unsuppressed viral load were significantly associated with intentional nonadherence. Reported reasons included being too busy, emotional distress, and running out of medication. These findings suggest that intentional and unintentional nonadherence represent distinct behavioral patterns, with intentional lapses more strongly linked to virological failure. Addressing substance use, simplifying regimens, and providing psychosocial support after disclosure are essential to optimize adherence and achieve UNAIDS 2030 targets.<\/jats:p>","DOI":"10.3390\/v17101375","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T13:41:29Z","timestamp":1760449289000},"page":"1375","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Behavioral Predictors of Intentional and Unintentional Nonadherence to Antiretroviral Therapy and Their Implications for Virological Failure Among People with HIV in Taiwan"],"prefix":"10.3390","volume":"17","author":[{"given":"Su-Han","family":"Hsu","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Taipei City Hospital Yangming Branch, Taipei 111, Taiwan"},{"name":"School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan"},{"name":"Department of Exercise and Health Sciences, University of Taipei, Taipei 111, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5455-4549","authenticated-orcid":false,"given":"Chien-Chun","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Taipei City Hospital, Linsen, Chinese Medicine, and Kunming Branch, Taipei 108, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4469-4732","authenticated-orcid":false,"given":"Yung-Feng","family":"Yen","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Internal Medicine, Taipei City Hospital, Heping Branch, Taipei 100, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsen-Fang","family":"Yen","sequence":"additional","affiliation":[{"name":"Department of Nursing, Taipei City Hospital, Linsen, Chinese Medicine, and Kunming Branch, Taipei 108, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po-Tsen","family":"Yeh","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Taipei City Hospital, Linsen, Chinese Medicine, and Kunming Branch, Taipei 108, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4917-8654","authenticated-orcid":false,"given":"Hsin-Hao","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Internal Medicine, Taipei City Hospital, Yangming Branch, Taipei 111, Taiwan"},{"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejim.2023.07.008","article-title":"The role of adherence in patients with chronic diseases","volume":"119","author":"Burnier","year":"2024","journal-title":"Eur. 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